Associations between female birth sex and risk of chronic kidney disease development among people with HIV in the USA: A longitudinal, multicentre, cohort study. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Women represent a meaningful proportion of new HIV diagnoses, with Black women comprising 58% of new diagnoses among women. As HIV infection also increases risk of chronic kidney disease (CKD), understanding CKD risk among women with HIV (WWH), particularly Black women, is critical. METHODS: In this longitudinal cohort study of people with HIV (PWH) enrolled in CFAR Network of Integrated Clinical Systems (CNICS), a multicentre study comprised of eight academic medical centres across the United States from Jan 01, 1996 and Nov 01, 2019, adult PWH were excluded if they had ≤2 serum creatinine measurements, developed CKD prior to enrollment, or identified as intersex or transgendered, leaving a final cohort of 33,998 PWH. The outcome was CKD development, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1·73 m2 calculated using the CKD-EPI equation, for ≥90 days with no intervening higher values. FINDINGS: Adjusting for demographic and clinical characteristics, WWH were 61% more likely to develop CKD than men (adjusted hazard ratio [aHR]: 1·61, 95% CI: 1·46-1·78, p<0·001). This difference persisted after further adjustment for APOL1 risk variants (aHR female sex: 1·92, 95% CI: 1·63-2·26, p<0·001) and substance abuse (aHR female sex: 1·70, 95% CI: 1·54-1·87, p<0·001). INTERPRETATION: WWH experienced increased risk of CKD. Given disparities in care among patients with end-stage kidney disease, efforts to engage WWH in nephrology care to improve chronic disease management are critical. FUNDING: US National Institutes of Health.

authors

  • Shelton, Brittany A
  • Sawinski, Deirdre
  • MacLennan, Paul A
  • Lee, Wonjun
  • Wyatt, Christina
  • Nadkarni, Girish
  • Fatima, Huma
  • Mehta, Shikha
  • Crane, Heidi M
  • Porrett, Paige
  • Julian, Bruce
  • Moore, Richard D
  • Christopoulos, Katerina
  • Jacobson, Jeffrey M
  • Muller, Elmi
  • Eron, Joseph J
  • Saag, Michael
  • Peter, Inga
  • Locke, Jayme E

publication date

  • September 17, 2022

Identity

PubMed Central ID

  • PMC9489495

Scopus Document Identifier

  • 85138092481

Digital Object Identifier (DOI)

  • 10.1016/j.eclinm.2022.101653

PubMed ID

  • 36159042

Additional Document Info

volume

  • 53